Understanding ‘Allergy’

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These are microscopic insects which breed in household dust and are one of the biggest causes of allergies worldwide and flourish at 16 to 24 Degree Celsius.

By Dr. Saud Ahmed

Allergy is a hypersensitive response by the body’s immune system to a substance that either enters or comes in contact with the body. A substance that causes an allergic reaction is called an ‘allergen’. Commonly encountered allergens are pet dander, pollen grains, dust mites, moulds, insect venom and food products.
Allergy occurs only in ‘susceptible individuals’ and can manifest in the form of asthma, rhinitis (runny nose), conjunctivitis (red and itchy eye), itchy skin lesions and life-threatening anaphylaxis leading to a sudden obstruction of airway requiring urgent medical care.

Management of Allergy
In India, nearly 20-30% of the population suffers from some form of allergy in their lifetime. The management of allergy starts with identifying the allergen which can be done by skin prick tests and certain Blood tests which measure the Serum Specific Immunoglobulin E, a marker for allergy. Once the allergen is indentified, preventive guidelines form the backbone of allergy management.

Preventive Guidelines for Allergy
A ) House Dust Mites
These are microscopic insects which breed in household dust and are one of the biggest causes of allergies worldwide and flourish at 16 to 24 Degree Celsius. Washing clothes at higher temperatures can tackle this problem.
Consider using plastic covered occlusive mattress and bedding covers (this acts as a barrier to dust mites and their droppings)
Choose tiled or hard floor coverings instead of carpet
Clean cushions, soft toys, curtains and upholstered furniture regularly either by washing or vacuuming them
Use synthetic pillows and acrylic duvets instead of woollen blankets or cotton bedding
Use a damp, clean cloth to wipe surfaces as dry dusting can spread the allergens further

B) Pets
Exposure to flakes of their dead skin, saliva and dried urine can cause allergies.
Keep pets outside as much as possible or limit them to one room, preferably one without carpet
Do not allow pets in bedrooms
Wash pets at least once a fortnight
Groom cats regularly outside
Regularly wash all bedding and soft furnishings your pet has been on

C) Pollen Grains
Most people are affected during spring and summer months because this is when most trees and plants pollinate.
Avoid line-drying clothes and bedding when the pollen count is high
keep doors and windows shut during mid-morning and early evening, when there is most pollen in the air
Clean your nose regularly (douching)
Shower, wash your hair and change your clothes after being outside
Avoid grassy areas, such as parks and fields, when possible
If you have a lawn, consider staying away from gardening
Iron your clothes before use

D) Mould Spores
Spores are released when there is a sudden rise in temperature in a moist environment, such as when central heating is turned on in a damp house, or wet clothes are dried next to a fireplace.
Keep your home dry and well ventilated. Especially when showering or cooking, open the vents.
Do not dry clothes indoors, store clothes in damp cupboards or pack clothes too tightly in wardrobes
Deal with any damp and condensation in your home

E) Food Allergens
Eating certain food items especially fruits and refrigerated foods aggravate allergies in some and these if known should be avoided.
Individuals requiring medical therapy are treated by way of tablets, skin creams, nasal sprays and inhalers. However for most of them, the recurrence of symptoms do occur on stopping medicines. Long term use with these medicines require change in dose from time to time and certain adverse events may be observed if used for several months or years. Moreover these medications do not have any role in modifying the ongoing process of allergy symptoms.
In recent years, a newer treatment modality called Allergen Specific Immunotherapy (ASI) makes the body to enhance its tolerance to allergens. The individual is administered the sensitive allergen with calculated fixed dose, which generates tolerance and symptoms gradually reduce and ultimately disappear after stopping the medications. Currently this is the only evidence based and approved disease modifying approach which promises total relief from symptoms and in turn enhancing the quality of life. This holds good especially to those allergens where the causative allergen is difficult to avoid like dust mites, pollen grains and insect allergies.
Sub Lingual Immunotherapy – SLIT (medicine administered below the tongue) is gaining popularity because of easy to administer and practically no adverse events . By delivering an optimum effective dose, the response to the therapy is remarkable.
Primecare has an integrated model of ENT and Allergy care which provides comprehensive care to the community. Apart from catering to the patient requirements at the hospital and medical centers, it also offers corporate health talks, awareness programmes and allergy screening at work places. This will generate a complete work up for allergy management and total solution to those who suffer from allergy disorders at working place.
(Dr Saud Ahmed is Consultant ENT Surgeon, Primecare Hospital, Bangalore
+91 9902237259 | [email protected] | www.primecare.in)